RT Journal
A1 Tseng C
T1 EXogenous insulin use and hypertension in adult patients with type 2 diabetes mellitus
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2006
FD June 12
VO 166
IS 11
SP 1184
OP 1189
DO 10.1001/archinte.166.11.1184
UL http://dx.doi.org/10.1001/archinte.166.11.1184
AB Background
Endogenous hyperinsulinemia, along with insulin resistance, is associated with hypertension. This study investigated the link between exogenous insulin use and hypertension in patients with type 2 diabetes mellitus.Methods
Using national health insurance records in Taiwan, data from 87 850 adult patients with type 2 diabetes mellitus were collected cross-sectionally with retrospective recall for onset of events. Data were analyzed to evaluate the strength of association, consistency, dose-response relationship, and temporality between exogenous insulin use and hypertension.Results
There were 5927 insulin users, who were characterized by being 1 year older in age, female preponderance, longer duration of diabetes, slightly lower body mass index, and less smoking but higher prevalence of hypertension with higher blood pressure. After adjustment for age, sex, body mass index, duration of diabetes, smoking, and parental hypertension, the odds ratios (95% confidence interval [CI]) for hypertension for patients using insulin for less than 5 years, 5 to 9 years, and 10 years or more were 1.14 (95% CI, 1.06-1.23), 1.35 (95% CI, 1.18-1.54), and 1.46 (95% CI, 1.24-1.74), respectively, compared with nonusers. In insulin users who did not have hypertension at the start of insulin use, the respective odds ratios for those using insulin for 5 to 9 years and 10 years or more were 1.5 (95% CI, 1.25-1.80) and 2.15 (95% CI, 1.72-2.70), respectively, compared with those using insulin for less than 5 years.Conclusions
In patients with type 2 diabetes mellitus, insulin users are at higher risk for development of hypertension. These observational data suggest the need for further study of the relationship between exogenous insulin use and hypertension.